P-10, r. 19.1 - Regulation respecting the extension or adjustment of a physician’s prescription by a pharmacist and the substitution of a medication prescribed

Updated to 20 June 2015

This document has official status.

chapter P-10, r. 19.1

Regulation respecting the extension or adjustment of a physician’s prescription by a pharmacist and the substitution of a medication prescribed

Pharmacy Act

(chapter P-10, s. 10, 1st par., subpar. h).

Professional Code

(chapter C-26, s. 95).

DIVISION I EXTENSION OF A PHYSICIAN’S PRESCRIPTION

1. A pharmacist enters in a patient’s record whether the pharmacist has accepted or refused to extend a physician’s prescription and the clinical justification for that decision.

The pharmacist also recommends that the patient obtain appropriate medical follow-up and enters the recommendation in the patient’s record.

O.C. 605-2013, s. 1.

2. A pharmacist must inform the attending physician of the extension made.

O.C. 605-2013, s. 2.

DIVISION II ADJUSTMENT OF A PHYSICIAN’S PRESCRIPTION

3. A pharmacist may modify the dose of a prescribed medication to ensure the safety of the patient, in particular to reduce the adverse effects of a medication, manage drug interactions, prevent organ failure, take into account the patient’s renal or hepatic function, take into account the patient’s weight, improve the patient’s tolerance to medication therapy or correct an obvious error in dosage.

O.C. 605-2013, s. 3.

4. A pharmacist may also modify the dose of a prescribed medication to ensure the achievement of therapeutic targets where the pharmacist obtains those therapeutic targets and, if applicable, special limits or contraindications from the attending physician.

Furthermore, a pharmacist who practises in a centre operated by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or within the meaning of the Act respecting health services and social services for Cree Native persons (chapter S-5), or within a group where the medical team shares or uses the same patient record, may modify, where there is a medical treatment plan, the dose of a prescribed medication to ensure the achievement of the therapeutic targets established in that plan.

O.C. 605-2013, s. 4.

5. A pharmacist who adjusts a physician’s prescription by modifying the form, dose, quantity or dosage of a prescribed medication must so notify the patient and enter the adjustment in the patient’s record along with the clinical justification of that decision.

In addition, where the pharmacist modifies the dose of a medication, the pharmacist must inform the attending physician of the adjustment made.

O.C. 605-2013, s. 5.

DIVISION III THERAPEUTIC SUBSTITUTION OF A MEDICATION

6. A pharmacist must, before substituting another medication for the medication prescribed, ensure that the pharmacist cannot obtain the medication from 2 pharmacies in the pharmacist’s region and from 2 wholesalers accredited by the Minister of Health and Social Services under section 62 of the Act respecting prescription drug insurance (chapter A-29.01).

O.C. 605-2013, s. 6.

7. The pharmacist must notify the patient of the substitution and enter in the patient’s record the steps taken to obtain a supply, the substitution made and the notice given to that effect to the patient.

O.C. 605-2013, s. 7.

8. The pharmacist must inform the attending physician of the substitution made.

O.C. 605-2013, s. 8.

9. (Omitted).

O.C. 605-2013, s. 9; S.Q. 2015, c. 8, s. 205.

REFERENCES

O.C. 605-2013, 2013 G.O. 2, 1512

S.Q. 2015, c. 8, s. 205